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Eye drops or eyedrops are liquid drops applied directly to the surface of the eye usually in small amounts such as a single drop or a few drops. Eye drops usually contain saline to match the salinity of the eye. Drops containing only saline and sometimes a lubricant are often used as artificial
tears Tears are a clear liquid secreted by the lacrimal glands (tear gland) found in the eyes of all land mammals. Tears are made up of water, electrolytes, proteins, lipids, and mucins that form layers on the surface of eyes. The different types of ...
to treat
dry eyes Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS), is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge, and easily fatigued eyes. Blurred vision may also occur. Symptoms rang ...
or simple eye irritation such as itching or redness. Eye drops may also contain one or more medications to treat a wide variety of
eye diseases This is a partial list of human eye diseases and disorders. The World Health Organization publishes a classification of known diseases and injuries, the International Statistical Classification of Diseases and Related Health Problems, or ICD-10. ...
. Depending on the condition being treated, they may contain steroids,
antihistamine Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provid ...
s, sympathomimetics, beta receptor blockers,
parasympathomimetic A parasympathomimetic drug, sometimes called a cholinomimetic drug or cholinergic receptor stimulating agent, is a substance that stimulates the parasympathetic nervous system (PSNS). These chemicals are also called cholinergic drugs because ace ...
s,
parasympatholytic A parasympatholytic agent is a substance or activity that reduces the activity of the parasympathetic nervous system. (The parasympathetic nervous system is often colloquially described as the "Feed and Breed" or "Rest and Digest" portion of the a ...
s, prostaglandins, nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics,
antifungals An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as cryp ...
, or
topical anesthetic A topical anesthetic is a local anesthetic that is used to numb the surface of a body part. They can be used to numb any area of the skin as well as the front of the eyeball, the inside of the nose, ear or throat, the anus and the genital area. To ...
s. Eye drops have less of a risk of side effects than do oral medicines, and such risk can be minimized by occluding the
lacrimal punctum The lacrimal punctum (plural ''puncta'') or lacrimal point, is a minute opening on the summits of the lacrimal papillae, seen on the margins of the eyelids at the lateral extremity of the lacrimal lake. There are two lacrimal puncta in the medial ...
(i.e. pressing on the inner corner of the eye) for a short while after instilling drops. Prior to the development of single-use pre-loaded sterile plastic applicators, eye drops were administered using an
eye dropper An eye dropper, also called Pasteur pipette or simply dropper, is a device used to transfer small quantities of liquids. They are used in the laboratory and also to dispense small amounts of liquid medicines. A very common use was to dispense e ...
, a glass pipette with a rubber bulb.


Shelf life

Although most bottles of eye drops contain preservatives to inhibit contamination once opened, these will not prevent contamination indefinitely. Ophthalmologists recommend keeping bottles for no longer than three months after opening. Eye drops that contain no preservatives are usually packaged in single-use tubes. Dispensers typically oversize the drops; the human eye can only handle about 25 microlitres.


Types and uses

Different pharmacological classes of eye drops can be recognized by patients by their different colored tops. For instance, the tops to dilating drops are a different color than anti-allergy drops.


Dry eyes

Eyes drops sometimes do not have medications in them and are only lubricating and tear-replacing solutions. There is a wide variety of
artificial tear Artificial tears are lubricating eye drops used to relieve dryness and irritation of the ocular surface. Dry eye syndrome (keratoconjunctivitis sicca) is a common ocular surface disorder and is characterized by disruption of the tear film and inc ...
eye drops that provide different surface healing strategies. One can find bicarbonate ions,
hypotonicity In chemical biology, tonicity is a measure of the effective osmotic pressure gradient; the water potential of two solutions separated by a partially-permeable cell membrane. Tonicity depends on the relative concentration of selective membrane ...
, high
viscosity The viscosity of a fluid is a measure of its resistance to deformation at a given rate. For liquids, it corresponds to the informal concept of "thickness": for example, syrup has a higher viscosity than water. Viscosity quantifies the inte ...
gels and ointments, and non-preserved types. They all act differently and therefore, one may have to try different artificial tears to find the one that works the best.


Steroid and antibiotic eye drops

Steroid and antibiotic eye drops are used to treat eye
infections An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
. They also have
prophylactic Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
properties and are used to prevent infections after eye surgeries. They should be used for the entire time prescribed without interruptions. The infection may relapse if the use of the medication is stopped.


Pink eye

Antibiotic eye drops are prescribed when infection
conjunctivitis Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The ...
is caused by bacteria but not when it is caused by a virus. In the case of allergic conjunctivitis, artificial tears can help dilute irritating allergens present in the tear film.


Allergies

Some eye drops may contain
histamine antagonists Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provides re ...
or nonsteroidal anti-inflammatory drug (NSAIDs), which suppress the optical mast cell responses to allergens including (but not limited to) aerosolized dust particles.


Glaucoma

Eye drops used in managing
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...
help the eye's fluid to drain better and decrease the amount of fluid made by the eye which decreases eye pressure. They are classified by their active ingredient and they include: prostaglandin analogs,
beta blockers Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack ( secondary prevention). They are ...
, alpha agonists, and carbonic anhydrase inhibitors. There are also combination drugs available for those patients who require more than one type of medication.


Mydriatic eye drops

These make the eye's
pupil The pupil is a black hole located in the center of the Iris (anatomy), iris of the Human eye, eye that allows light to strike the retina.Cassin, B. and Solomon, S. (1990) ''Dictionary of Eye Terminology''. Gainesville, Florida: Triad Publishing ...
widen to maximum, to let an optometrist have the best view inside the
eyeball Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and con ...
behind the iris. Afterwards in sunny weather they can cause dazzling and
photophobia Photophobia is a medical symptom of abnormal intolerance to visual perception of light. As a medical symptom photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of ...
until the effect of the
mydriatic Mydriasis is the dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response. Non-physiological causes of mydriasis include disease, trauma, or the use of certain types of drugs. Normally, as ...
has worn off. In some countries including
Russia Russia (, , ), or the Russian Federation, is a transcontinental country spanning Eastern Europe and Northern Asia. It is the largest country in the world, with its internationally recognised territory covering , and encompassing one-eig ...
and
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...
, Tropicamide, a mydriatic eye drop, is used to some degree as an inexpensive recreational drug. Like other anticholinergics, when taken recreationally, tropicamide acts as a deliriant. When injected intravenously, as is most often the case, the tropicamide may cause problems such as slurred speech, unconsciousness, unresponsiveness, hallucinations, kidney pain, dysphoria, hyperthermia, tremors, suicidal tendency, convulsions, psychomotor agitation, tachycardia and headache.


Injectable medication

Syringe designed saline drops (e.g. Wallace Cameron Ultra Saline Minipod) are distributed in modern
needle-exchange programme A needle and syringe programme (NSP), also known as needle exchange program (NEP), is a social service that allows injecting drug users (IDUs) to obtain clean and unused hypodermic needles and associated paraphernalia at little or no cost. It ...
s as they can be used efficiently either by injection or ophthalmic (if the drug is potent in small doses) route of administer which is compared to intravenous use; by demonstration, the elimination of latanoprost acid from plasma is rapid (half-life 17 minutes) after either ophthalmic or intravenous administration.


Side effects

Steroid and antibiotic eye drops may cause stinging for one or two minutes when first used and if stinging continues, medical advice should be sought. Also, one should tell their doctor if vision changes occur or if they experience persistent
sore throat Sore throat, also known as throat pain, is pain or irritation of the throat. Usually, causes of sore throat include * viral infections * group A streptococcal infection (GAS) bacterial infection * pharyngitis (inflammation of the throat) * to ...
,
fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...
, easy
bleeding Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...
or
bruising A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur clos ...
when using drops with chloramphenicol. Also, one should be aware of symptoms of an allergic reaction, such as:
rash A rash is a change of the human skin which affects its color, appearance, or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, c ...
,
itching Itch (also known as pruritus) is a Wikt:sensation, sensation that causes the desire or reflex to scratch. Itch has resisted many attempts to be classified as any one type of Sensory system, sensory experience. Itch has many similarities to pain, ...
, swelling,
dizziness Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness. It can also refer to disequilibrium or a non-specific feeling, such as giddiness or foolishness. Dizziness is a common medical c ...
, and trouble breathing. Long term steroid use can cause many adverse effects including steroid-induced
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...
and
cataract A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble ...
. Prostaglandin analogs may cause changes in
iris Iris most often refers to: *Iris (anatomy), part of the eye *Iris (mythology), a Greek goddess * ''Iris'' (plant), a genus of flowering plants * Iris (color), an ambiguous color term Iris or IRIS may also refer to: Arts and media Fictional ent ...
color and
eyelid An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eye ...
skin, growth of
eyelashes An eyelash (also called lash) (Latin: ''Cilia'') is one of the hairs that grows at the edge of the eyelids. It grows in one layer on the edge of the upper and lower eyelids. Eyelashes protect the eye from debris, dust, and small particles and p ...
, stinging, blurred vision, eye redness, itching, and burning. Beta blockers' side effects include
low blood pressure Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure (the top number) and the di ...
, reduced pulse rate, fatigue, shortness of breath, and in rare occasions, reduced
libido Libido (; colloquial: sex drive) is a person's overall sexual drive or desire for sexual activity. Libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act u ...
and depression. Alpha agonists can cause burning or stinging, fatigue, headache,
drowsiness Somnolence (alternatively sleepiness or drowsiness) is a state of strong desire for sleep, or sleeping for unusually long periods (compare hypersomnia). It has distinct meanings and causes. It can refer to the usual state preceding falling asleep ...
,
dry mouth Xerostomia, also known as dry mouth, is dryness in the mouth, which may be associated with a change in the composition of saliva, or reduced salivary flow, or have no identifiable cause. This symptom is very common and is often seen as a side eff ...
and
nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes ...
, and also they have a higher likelihood of allergic reaction. Carbonic anhydrase inhibitors may cause stinging, burning, and eye discomfort. Lubricant eye drops may cause some side effects and one should consult a doctor if pain in the eye or changes in vision occur. Furthermore, when redness occurs but lasts more than 3 days, one should immediately consult a doctor.


See also

*
Artificial tears Artificial tears are lubricating eye drops used to relieve dryness and irritation of the ocular surface. Dry eye syndrome ( keratoconjunctivitis sicca) is a common ocular surface disorder and is characterized by disruption of the tear film and i ...
*
Carboxymethyl cellulose Carboxymethyl cellulose (CMC) or cellulose gum is a cellulose derivative with carboxymethyl groups (-CH2-COOH) bound to some of the hydroxyl groups of the glucopyranose monomers that make up the cellulose backbone. It is often used as its sodi ...
* Mydriasis *
Refractive error Refractive error, also known as refraction error, is a problem with focusing light accurately on the retina due to the shape of the eye and or cornea. The most common types of refractive error are near-sightedness, far-sightedness, astigmatism ...
* Tetrahydrozoline hydrochloride * Visine


References


External links

* * {{DEFAULTSORT:Eye Drop Dosage forms Drug delivery devices Ophthalmology drugs Ophthalmic drug administration